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Sex Differences in the Impact of Aortic Valve Calcium Score on Mortality After Transcatheter Aortic Valve Replacement

Parth P Patel1, Abdallah El Sabbagh2, Patrick W Johnson3

  • 1Mayo Clinic Alix School of Medicine, Jacksonville, FL (P.P.P.).

Circulation. Cardiovascular Imaging
|August 3, 2022
PubMed

Insights

Aortic valve calcium score (AVCS) predicts mortality after transcatheter aortic valve replacement (TAVR). Higher AVCS increases mortality risk in women, but not men, after TAVR.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Geriatric Medicine

Background:

  • Transcatheter aortic valve replacement (TAVR) is a standard treatment for severe aortic stenosis.
  • Identifying predictors of mortality post-TAVR is crucial for patient management.
  • Aortic valve calcium score (AVCS) is a potential risk stratification tool.

Purpose of the Study:

  • To investigate the association between aortic valve calcium score (AVCS) and long-term mortality after TAVR.
  • To evaluate potential sex differences in this association.

Main Methods:

  • Retrospective analysis of 2543 patients undergoing TAVR from 2010-2021.
  • Aortic valve calcium score (AVCS) derived from preoperative CT scans.
  • Kaplan-Meier curves and Cox regression models used for mortality analysis.

Main Results:

  • Higher AVCS was associated with increased mortality risk post-TAVR (P<0.001).
  • A sex difference was observed: each 500-unit AVCS increase correlated with a 7% mortality risk increase in women (aHR, 1.07 [95% CI, 1.02-1.12]), but not men.

Conclusions:

  • A significant sex difference exists in the relationship between AVCS and long-term mortality following TAVR.
  • AVCS may enhance preprocedural risk stratification for women undergoing TAVR.
  • Further research is warranted to confirm these findings.
Abstract

Keywords:
aortic valve stenosismortalityrisksex differencesex differencestranscatheter aortic valve replacement

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